Myoepithelial carcinoma (MC) and myoepithelioma can be considered as doppelgangers, as they are difficult to distinguish due to diverse morphology and MC have infavorable outcome. Published reports suggest that MC comprise of <2% of all salivary gland carcinomas involving parotid gland most commonly. Other sites involved are palate, maxilla, nasopharynx, liver, vulva and vagina. However, this may be just a tip of the iceberg as due to increased recognition of this tumor, its incidence may be changed and may vary depending on demography. In fact, it is now believed that this tumor is the second-most common salivary gland malignancy arising from the benign adenomas. It may also arise de novo. An accurate diagnosis for MC relies on exclusive myoepithelial differentiation (morphologic and immunohistochemical [IHC]) and clear-cut tumor infiltration into adjacent salivary gland or other tissues. Bases on above findings the present study was planned for clinical evaluation of high grade myoepithelial carcinoma of the maxillary sinus in patients admitted to ANMMCH, Gaya. The present study was planned in Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar. Total 15 cases of the myoepithelial carcinoma of the maxillary sinus were enrolled in the present study. The cases were histo pathologically confirmed cases of malignancies of nose and Para nasal sinuses are studied with regard to their clinical presentation, radiology, histopathology and treatment protocols. The data generated from the present study concludes that the malignancies of the nose and Para nasal sinuses are an intriguing group of disorders due to the variations in their clinical presentation, histopathological diagnosis, staging and grading. The type of treatment modality also varies depending upon the aforementioned factors. The challenge lies in diagnosing the malignancy as early as possible followed by selecting an appropriate treatment option and adequate follow up.